Healthcare Provider Details

I. General information

NPI: 1285631846
Provider Name (Legal Business Name): ENRIQUE HERNANDEZ-SANCHEZ M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: ENRIQUE HERNANDEZ M.D.

II. Dates (important events)

Enumeration Date: 06/28/2005
Last Update Date: 03/14/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9980 CENTRAL PARK BLVD N STE 316
BOCA RATON FL
33428-1704
US

IV. Provider business mailing address

9980 CENTRAL PARK BLVD N STE 316
BOCA RATON FL
33428-1704
US

V. Phone/Fax

Practice location:
  • Phone: 561-206-6064
  • Fax: 561-206-6032
Mailing address:
  • Phone: 561-206-6064
  • Fax: 561-206-6032

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0206X
TaxonomyPediatric Gastroenterology Physician
License NumberME89234
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: